Adolescent and young adult (AYA) oncology
Cancer in people aged 15-39, about 90,000 US cases a year, with a distinct mix of cancers, slower survival improvement than children or older adults, and specific needs: fertility, education and work, psychosocial support and trial access.
AYA cancers include lymphoma, thyroid, testicular, melanoma, breast, colorectal (rising sharply in under-50s), sarcomas, leukaemia and CNS tumours. Survival gains lagged for decades (the 'AYA gap') because of low trial enrolment, delayed diagnosis, biology (e.g. Ph-like ALL, worse-prognosis sarcoma subtypes) and care fragmented between paediatric and adult systems; paediatric-inspired ALL regimens in AYAs improved survival (CALGB 10403). Dedicated AYA programmes (Teenage Cancer Trust UK, NCI AYA Oncology Progress Review Group 2006, COG/NCTN AYA committee) address fertility preservation, psychosocial care, financial toxicity, survivorship and age-appropriate environments. Early-onset colorectal and breast cancer incidence increases are a current research priority.
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